Zip Codes Can Impact Breast Cancer Care

Breast cancer treatment discrepancies found for rural women

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Where you live shouldn’t affect how you’re treated for cancer or any other disease. However, a recent study found that women living in rural communities could be getting better cancer care than they currently are.

Compared to women living in urban areas, rural women were less likely to get recommended treatments for breast cancer, according to this study.

Rural women commonly didn’t have their tumors fully analyzed. They often had different types of surgery and were less likely than their urban counterparts to receive radiation therapy after surgery.

"Make sure you get the correct follow-up care for your cancer."

Elizabeth Habermann, PhD, associate scientific director of Surgical Outcomes at the Mayo Clinic Center for the Science of Health Care Delivery, was the study’s lead investigator. She worked with colleagues at Georgetown University Hospital and the University of Minnesota.

These researchers analyzed California Cancer Registry data for the years 1996 to 2008. Information about nearly 350,000 women with all stages of breast cancer was examined.

Here’s what the analysis uncovered:

  • Women living in rural areas were less likely than city dwellers to have their tumor graded and analyzed for estrogen receptor (ER) status. Grading has to do with how fast the tumor is likely to grow, and ER status informs physicians about what’s driving cancer growth.
  • Rural women had more mastectomies (removal of the entire breast), while urban women were more likely to have lumpectomies, breast-conserving surgeries that remove only the tumor and surrounding tissue.
  • Women from rural areas who did have a lumpectomy were less likely than urban women to have radiation therapy, which is recommended to kill remaining cancer cells following surgery. 
  • Despite these differences, there was no significant difference in breast-cancer related deaths among the two groups.

"The study basically confirms previous reports that show living in rural areas leads to a lower use of breast conserving therapy and post-lumpectomy radiation therapy — both considered standards of care for appropriately selected woman with early stage breast cancer," Frank Vicini, MD, FACR, radiation oncologist at 21st Century Oncology in Royal Oak, MI, told dailyRx News. 

"These unfortunate deficiencies are the result of many factors, but partially reflect issues related to limited access for radiation facilities or breast specialists. Efforts need to be made to expand access and to improve the dissemination of state-of-the-art information on options for breast cancer treatment," Dr. Vicini said.

According to the study authors, further research is needed to learn more about why these differences exist so that strategies can be developed to address the gaps.

Findings from this study were presented at the Academy Health Annual Research Meeting. All research is considered preliminary before it is published in a peer-reviewed journal.

The study was funded by the National Institutes of Health.

Review Date: 
June 26, 2013
Last Updated:
September 6, 2013